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Tiny Tip | Canadian C-spine Rule Mnemonic

In Tiny Tips by Teresa Chan4 Comments

Clinical Decision Tool uptake In 2007, Dr. Ian Stiell wrote a paper [1] about the uptake and real-life implementation of his four clinical decision rules (or as we prefer to call them, clinical decision tools).  The paper concludes that “Future research should identify implementation barriers and explore strategies to achieve better knowledge uptake in the ED”. The BoringEM team hypothesizes that the ease of use may be greatly affected by the complexity of a rule itself …

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Tiny Tip: Determining capacity in an emergency – The CURVES Mnemonic

In Tiny Tips by Brent ThomaLeave a Comment

Determining capacity in a patient that needs to make an emergency medical decision can be a huge challenge for emergency physicians with substantial legal and patient-oriented consequences. As emergency medicine providers we need to be able to make this determination confidently and decisively. By preparing our approach in advance we can be more confident in our decisions. In November 2014, EM:RAP (check it out!) had a great segment on decision making capacity and …

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Tiny Tip: C BIG K DROP (Management of Hyperkalemia with ECG changes)

In Tiny Tips by Ping Yu Xiong4 Comments

Editors Note: As you know, BoringEM has never shied away from controversy. In this Tiny Tip, we present to you a mnemonic for the management of hyperkalemia with ECG changes – wrought with several interesting suggestions with which MANY will avidly jump to post-publication peer review.  We welcome the opportunity to engage with you and your comments below.  Of note, please stay tuned for the official “debrief” in this discussion on Thursday, September …

Boring Question: Does this medication cause long QT? (with Bonus: Tiny Tips!)

In Clinical Questions, Tiny Tips by Jatin Kaicker7 Comments

The Clinical Case A 70-year-old female presents to the emergency department with new palpitations and 2 syncopal episodes, witnessed by her son. These episodes have started within the past 10 days. Her past medical history includes diabetes, hypertension, depression, dyslipidemia and atrial fibrillation. She is a long-standing diabetic and is followed by a nephrologist for her diabetic nephropathy. Her medications included: metformin, atorvastatin, aspirin, warfarin and sertraline. She was recently seen in hospital …

Tiny Tip: PREeclampsia

In Tiny Tips by Sarah Luckett-Gatopoulos3 Comments

Preeclampsia is a common complication in pregnancy, affecting 3-5% of pregnant women in the general population, and up to 25% of pregnant patients with pre-existing chronic hypertension [1].

Tiny Tip: HELLP Syndrome

In Tiny Tips by Sarah Luckett-Gatopoulos1 Comment

If you train in a tertiary care center with obstetrical triage, you may not assess many pregnant women beyond the first trimester of pregnancy. However, in community emergency departments without a primary obstetrics triage department, you will often encounter pregnancy-induced hypertension (PIH; systolic pressure 140 mmHg, or diastolic pressure 90 mmHg), a common complication occurring in 7-9% of pregnancies. HELLP syndrome is an important subset of PIH that comes with its own built-in mnemonic …